Three Things You (Probably) Don't Know About Depression

One of the great things about writing psychology books is that I can justify spending hours and hours reading about the latest research studies and trying to figure out what they mean to a) those of us trying to help sufferers get well and b) mental health consumers who need to stay well-informed so they can make sure they get the best possible treatment.

In that spirit, here are three findings from recent research studies and my take on what they might mean.

So what? This study was cross-sectional, meaning it can’t tell us if chocolate contributes to depression or is eaten in an attempt to feel better although anecdotal accounts support the latter. If true, it’s possible that intense chocolate cravings – especially during times of stress – may signal the onset of depression.

2. A 2010 study from Rhode Island Hospital found that, when asked specifically about them via a self-report questionnaire, patients reported 20 times more side effects from their medication than had been recorded in their charts by their psychiatrists. Furthermore, the only side effective physicians routinely asked about was sexual dysfunction.

So what? There are many antidepressants that provide similar therapeutic benefit but may cause different side effects in different individuals; in fact, it’s pretty common for a person to try two or three antidepressants before finding the magical combination of low side effects and good treatment response. If you’re starting an antidepressant, do your own research into the possible side effects, keep track of any you experience (don’t wait for your doctor to ask you), and always discuss them with your doctor before discontinuing them.

3. Depression and anxiety disorders frequently coexist and the causes for both are strongly linked to stressful experiences. Two new research studies have discovered biological links between stress, anxiety and depression. For some genetically predisposed individuals, stress abnormally increases corticotrophin releasing factor 1, which then works to increase specific types of serotonin receptors in the brain (which have been linked to depression).

So what? This is exciting news. First of all, finding ways to disrupt this connection may open doors for new advances in treatment for depression and anxiety. On a personal level, individuals with a family or personal history of depression may do well to incorporate specific stress management techniques (relaxation, medication, yoga) into their daily lives, both as a buffer against potential stress-inducing depression and as an adjunct to more traditional mental health treatment.

In my opinion, it takes way too long for the people who most need new information to actually get it. Have any ideas about how to shorten this gap? I’d love to hear them.

Like all behavioral/mental/brain disorders, we find that the personalized and socio-cultural ways of making sense of this experience, while offering a quick way to process the pain and complexity, lead usually to stigma and demonizing of the afflicted and oneself.

Understandable, our minds seek out simple explanations, but largely ineffective for understanding and treating the diseases.

This is a huge obstacle to communications and just getting the word out. We find that the mentally ill brain is also very clever and expends a great deal of energy, the higher the IQ - the greater, at generating a constant stream of self-talk about treatment as a threat. Sadly, along with the theme: "The world will be better off without me."

We have found that sharing basic brain research, explanations and models are helpful. Moving from moral/religious/socio-cultural/self-help/blaming-shaming frames to a medical model is not only fact-based but appealing to many. Or just adding in the medical model as another way to understand mental illness, not to exclude any others.

Since the facts are that these are largely genetic and inherited conditions, discussing that moderates blame and can trigger familiar childhood experiences with the diseases in the parents and relatives.